Hybrid Medical Coding Auditor – Risk Adjustment

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About the role

  • Medical Coding Auditor ensuring accuracy in diagnostic coding within healthcare records. Evaluating coding behavior and collaborating on quality assurance for healthcare providers.

Responsibilities

  • Analyze medical claims data and associated documentation to ensure accurate and complete diagnostic risk capture.
  • Document findings, including diagnosis changes and opportunities for documentation improvement, and recognize trends.
  • Evaluate coding and documentation behavior, providing recommendations for provider improvement.
  • Interpret and apply policy and coding standards (e.g., Coding Clinic) that impact financial and operational aspects of risk adjustment coding.
  • Collaborate and communicate effectively with internal and external sources to deliver QA findings.

Requirements

  • Bachelor's degree or four (4) years of relevant work experience (Required)
  • Three (3) years of experience as a RHIA, RHIT, or CPC certified coder within a healthcare provider organization or health insurance company (Required)
  • Current certification as a professional coder (RHIA, RHIT, or CPC) (Required)
  • CRC certification or willingness to obtain it within the first year of employment.
  • Additional certifications such as CCSP, CCS-H, CPC-P, and CPH-H are desirable.
  • Nursing or other clinical experience is a plus.

Benefits

  • Medical, vision, and dental coverage with low employee premiums.
  • Voluntary benefit offerings, including pet insurance for paw parents.
  • Life and disability insurance.
  • Retirement programs, including a 401K employer match and a pension plan that is vested after 3 years of service.
  • Wellness incentives with a wide range of mental well-being resources for you and your dependents.
  • Generous paid time off to reenergize.
  • Tuition assistance for both undergraduate and graduate degrees.
  • Employee recognition program to celebrate anniversaries and team accomplishments.
  • Commuter perks and free on-site parking.
  • Subsidized on-campus cafes.

Job title

Medical Coding Auditor – Risk Adjustment

Job type

Experience level

Mid levelSenior

Salary

$57,100 - $91,400 per year

Degree requirement

Bachelor's Degree

Location requirements

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